Adverse health outcomes for prostate cancer patients treated with radiotherapy combined with androgen-deprivation therapy: A population-based, controlled study, from Norway.

Abstract

Background and purpose: The aim of this controlled cross-sectional, and population-based study was to evaluate adverse health outcomes (AHOs) 3 years after curative radiotherapy (RT) + androgen deprivation therapy (ADT). We also assessed Global Health/Quality of Life (QoL).

Patients/material and methods: The Cancer Registry of Norway (CRN) provided data on prostate cancer (PCa) patients diagnosed in 2017-2019. All had been treated with RT+ ADT. All had completed EPIC-26 and EORTC QLQ-C30 about 3 years after RT start (n = 663). ADT duration was stratified: Short (< 9 months), intermediate (9-18 months) and long ADT (18-24 months). A group of controls were established from the general population (n = 1,817). Outcome measures were the urinary irritative/obstructive domain summary score (DSS), the bowel and sexual DSSs (EPIC-26) and QoL (EORTC QLQ-C30).

Results: Compared to controls, patients had clinically important lower bowel, and sexual mean scores. Urinary irritative/obstructive DSS levels were similar. Overall, 43% (PCa patients) and 20% (controls) reported major sexual problems. In patients aged < 75 years, longer than short ADT duration significantly decreased sexual DSS. QoL was relatively unaffected. Low response rates, selection bias and a lack of pre-treatment data represent the studys´ limitations.

Conclusion and interpretation: Three years post-RT+ADT, PCa patients describe clinically important lower EPIC-26 bowel and sexual DSS compared to controls. Sexual domain levels decreased with increasing ADT duration, particularly in patients < 75 years. Our observations indicate worse AHOs than previously reported and should be considered during pre-treatment counselling of PCa patients.